The amount of professional media a GP receives is huge. In some
weeks, a doctor having a quiet week - a very rare occurrence - could
plough through 360 tabloid pages delivered free to his or her door.
In addition, there are around ten fortnightly or monthly magazines, all
controlled circulation and dealing with practice, finance or clinical
This sector of the industry is kept afloat, or more accurately,
extremely profitable, by a single source of revenue; display advertising
from the pharmaceutical industry, a spend estimated at between pounds 30
million and pounds 35 million a year.
It is a relatively stable market, governed largely year on year by how
many drugs the industry launches. A pharmaceutical company’s adspend on
a launch is huge compared with the amount spent on maintaining a brand -
and last year proved a busy period. Of the top ten promoted products in
1997, half were launched the previous year.
The three weekly titles, Pulse, GP and Doctor, now account for 67 per
cent of the spend - or 55 per cent of the pages. This leaves 25 per cent
of the pages for the fortnightlies and 20 per cent for the
The spend reflects GPs’ position as gatekeepers of the NHS. Prescribing
by brand name is originated in general practice. Hospital doctors
contribute significantly less to the national drugs bill and tend to
prescribe generic rather then branded products. Prescribing by practice
nurses has had a patchy uptake but is in the process of being rolled out
nationally. However, this is unlikely to allow the nursing press to cash
in on the spend from drugs companies. Almost everything a nurse can
prescribe is already available over the counter.
The two main pushes for a drug company looking to establish a lead for
its product are print advertising and a targeted salesforce, with both
aspects co-ordinated especially for a launch.
The print advertising will often be there to simply establish brand
familiarity and very few include detailed clinical information about the
drug, except for the details demanded by legislation.
The sales representative will then follow up with one-to-one meetings
with GPs, using detail aids and leave pieces.
But it is the medical press that forms the mainstay of a company’s
promotional efforts and this is largely a result of the huge target
penetration they afford. Mike Bohling, the director of GEM Associates,
one of the leading media buyers in this sector, says of the market: ’GP
and Pulse record readership figures of 70 to 75 per cent each for an
average issue and I can’t think of any other market that could claim
that. It’s a huge penetration.’
A media buyer can approach 100 per cent penetration with the right
combination of titles.
Andy Thompson, publishing director of the medical division of Miller
Freeman, which publishes Pulse, agrees. ’It’s an unusual market in that
you can get 99 point something per cent of the potential readership by
using the media,’ he says.
Pulse fights a close-run battle for market leader status with GP. Doctor
lags behind by 15 points and the rest further still. The only exception
to this is MIMS, the Monthly Index of Medical Specialities, which
consistently scores higher than Pulse and GP.
MIMS is the only free title that sits on most GPs’ desks. It is a
detailed run-down of the majority of drugs a GP prescribes, providing
details of which conditions a particular drug is useful for and what to
look out for if a patient is taking it.
Its competitor is the British National Formulary, published by the
British Medical Association and the Royal Pharmaceutical Society, which
focuses on generic rather than branded goods and does not accept display
Media buyers control the adspend of practically every pharmaceuticals
company. Glaxo Wellcome decided to place its spend in the hands of GEM
Associates late last year and became the last major company to do
What is placed where and how much is paid for it depends almost
completely on a readership survey, JICMARS, the Joint Industry Committee
of Medical Advertisers for Readership Surveys.
Trying to get an idea of who reads what for a controlled circulation
market is notoriously difficult when ABCs tell you only how many are
being mailed out. The medical market is no exception. JICMARS is
financed by publishers and pharmaceutical companies through their media
buyers, and representatives from each contributor sit on the
A technical committee oversees the interviewing of 1,000 GPs to glean
their reading habits. Flash cards of covers are shown to them and the
degree of recognition recorded (see table).
The industry contributes to the pounds 160,000 cost of the survey,
although the bulk of the expenses are met by Haymarket, Miller Freeman
An extra pounds 50,000 is spent on the Taylor Nelson Hospital Readership
Survey which attempts to find out what the (less lucrative) hospital
doctor market is reading.
Bohling is sanguine about the accuracy of JICMARS and believes that the
way it ranks publications is more important than the actual figures.
’JICMARS is the common currency and that’s why it is used. Although
other surveys have been set up, JICMARS’ position has not really been
challenged,’ he says. ’As the for the precise nature and variance of the
readership figures, at the end of the day we still get to our target
audience in a very targeted way. But it’s true that we don’t have
anything approaching TGI.’
But publishers’ attitudes to how accurately their titles are served by
JICMARS are neatly - but predictably - divided by how well their titles
Miller Freeman’s Thompson answers a firm ’yes’ when asked whether he
believes the actual figures to be accurate, as well as the trends and
ranking. ’Individuals express doubts about it from time to time but I
sit on the JICMARS committee and believe it to be a reasonably accurate
survey of readership,’ he explains.
A new system that aims to challenge JICMARS was launched early last year
but still has to prove its worth, according to publishers and media
Topix allows existing databases to interact and includes a survey
involving 200 face-to-face interviews carried out every month.
Its panel consists of a sample that aims to be representative of region,
sex and size of GP practice, and it aims to have no duplicate interviews
within a 12-month period. It is only sold to the pharmaceutical industry
and publishers and the data is only available to media buyers through
As a rival to JICMARS it is in its early stages and JICMARS ranking is
still the most important factor for media buyers. ’Because we and GP are
relatively close, if we ever went into second place it would be harder
to get the premium rate we do now,’ Thompson says.
Dr Farine Clarke, managing director of Haymarket Medical, publisher of
GP, MIMS and Medeconomics - which all score highly in JICMARS - is more
doubtful of the absolute accuracy of the figures per se.
A GP herself, she says: ’The numbers have a confidence interval of plus
or minus 3 per cent and therefore have to be taken in context. GPs do
not always answer the questions accurately.’
Ian Heslop, the publishing director of Reed Healthcare, which publishes
Doctor, Hospital Doctor and Update, says: ’JICMARS has always prided
itself on maintaining a very high standard and, although it has often
been criticised for being slow to react, that has been largely because
it has wanted to ensure that any changes to its methodology are well
But he points out that his strategy is not only to pour resources into
improving the JICMARS score but also to create a brand rather than just
Brand extension is an activity all three of the major publishers are
involved in. Doctor has launched a credit card, a travel club, a club
for buying medical equipment and the prestigious Doctor of the Year
award for excellence in practice. In April last year, GP launched a
separate clinical title, GP Medicine, out of its parent title and also
produces a series of branded guides.
All the leading titles have plans to introduce online services but Pulse
will be the first off the blocks when epulse is launched this month.
Thompson says: ’This is not Pulse online but a new-media service that
will offer GPs the chance to buy services such as equipment for their
surgery, wine and holidays online. The opportunity to buy courses for
continuing medical education will also be included.’
Although the site has no sponsors as yet, Miller Freeman will welcome
applications from companies to display banners or links to their own
Websites when epulse is up and running.
However, Haymarket’s Clarke is doubtful about the current level of
demand for such a facility. ’Although GPs have computer systems to
generate prescriptions or keep patient records, our research shows that
very few access the Internet at the moment,’ she says. ’Having said
that, Haymarket Medical is actively developing an Internet site for
launch in the first quarter of 1998.’
Despite stories of the pharmaceutical industry falling on leaner times,
the future for the medical press looks stable. Although this year saw
media spend running at 5 per cent less than the previous year, it was a
good year for launches and the traditional fallow August period proved
to be unusually buoyant.
But a glance at JICMARS over the past year seems to suggest that the
level of readership is dropping across the board. GPs seem to be simply
reading less. Steve Lederer, the editor of Pharmaceutical Marketing and
ex-editor of GP, believes readership figures have been in decline for
some time, partly because of the increase in GPs’ workloads and also
thanks to the demands from other media.
’When I first joined the medical market ten years ago, we all knew that
the magazines would be delivered to a GP’s home on Thursday or Friday
and GPs would spend a lot of time enjoying them over the weekend, but
that perception is long gone,’ he says. ’Titles are now delivered to the
surgery earlier in the week and read quickly between seeing
The volume must be intimidating. I know from talking to GPs that many
find it distressing in terms of wasted resources, not only paper but
also in man hours.’
But a real decline in readership is simply not evident say the
publishers and yet another magazine joined the ranks last month.
Women in General Practice is published by Simon Warne at Emap
Healthcare. He says: ’The GP market has always been buoyant, supporting
a large number of titles headed by the big three weeklies. However, in
recent years GPs have been looking for more specialist publications
which cater more specifically for their needs - and this is certainly
true of women GPs.’
His optimistic attitude on the health of the GP market is shared by the
other publishers. Clarke says: ’The pharmaceuticals market is very
healthy and while GP and Pulse continue to get such huge coverage I
don’t really see the situation changing.’
Thompson agrees: ’I think in common with industries throughout the UK,
costs have been minimised in the pharmaceuticals industry but I would
strongly disagree with anyone who said the industry was scaling down in
any major way.
JICMARS Score 1997
PUBLICATION Jan-Dec 96 July 96- Last six %
June 97 months
British Medical Journal 61 60 60 -1
Doctor 65 60 57 -8
GP 75 73 71 -4
Pulse 76 73 71 -4
BMA News Review 48 43 39 -9
Medical Monitor 43 43 42 -1
Prescriber 24 25 27 +3
Update 48 46 43 -5
Financial Pulse 47 45 46 -1
Medeconomics 63 63 64 +1
British Journal of Cardiology 11 10 9 -2
Practitioner 46 47 51 +5
MIMS 82 83 83 +1
Medical Interface 4 5 6 +2
British Journal of General
Practice 28 27 29 +1
Geriatric Medicine 17 16 16 -1
Health and Ageing - 12 12 n/c